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A 27 year old female patient with pulmonary adenoid cystic cancer was planned for emergency tracheotomy for hemoptysis and severe dyspnea. Six month previously she had a silicon tube (5.5 mm-ID, 40 mm in length) placed in her trachea, because of severe tracheal stenosis. Airway management by endotracheal intubation was deemed necessary during the tracheotomy. However, because of her tracheal narrowing, it was not possible to insert a usual endotracheal tube for adult. First, we made a 4.0 mm-ID endotracheal tube without cuff 12 cm in length (TUBE 1), and a 5.5 mm-ID tube 18 cm in length (TUBE 2). We inserted the TUBE 1 into the TUBE 2, and glued them with Aron-Alpha, making it 25 cm long. We could perform tracheotomy by intubating and wedging this tube into silicon tube.
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